In 1955, a woman named Shirley Mason
visited the psychotherapist she’d been seeingfor a few months.
When the therapist asked her how she was doing,
she said, “ I ’ m fine but Shirley isn ’ t.
She was so sick she couldn’t come, so I came instead…
Through continued therapy, the therapist discovered what seemed like
16 personalities living inside Shirley’s mind.
She later wrote a now-famous book about Shirley, titled”Sybil”—
using a different name to protect her patient’s privacy.
And that book put a rare syndrome,
then called multiple personality disorder, on the map.
Before Sybil, fewer than 100 cases had ever been reported,
but after the book came out, diagnoses explodedinto the thousands.
In a surprising twist,
Shirley ’ s specific case might not have been real,
and she eventually wrote her therapist claiming she’d made it all up.
But researchers are still looking into thedisorder as a whole. Today,
we call Shirley’s diagnosis dissociativeidentity disorder, or DID.
It often occurs alongside other psychiatricdisorders,
making diagnosis very difficult.
And it’s still very controversial among psychologistsand psychiatrists.
But what ’ s not controversial is
that the way Hollywood portrays it is way off.
To be diagnosed with DID, a patient needsto have
two or more so-called “identities”, orpersonality states.
This doesn’t necessarily mean a whole otherperson
is living inside their mind.
In many cases, it’s more like their overallpersonality is fragmented,
and different parts of their history and self-imagecan take control.
For example, only one personality state mightbe able to
speak a language learned during a semesterabroad in college,
while another doesn’t remember that experience.
Or if they’d previously been a very religiousperson,
they might have one fragment of them that ’ s devout,
and another that isn ’ t.
Sometimes these fragments present themselvesas multiple people
with different ages or genders, but not always.
And while these fragments can be complicated,
with their own wants and aspirations, they
aren’t there to fulfill,like, evil or criminal desires.
So the idea that people with DID are ruled
by the worst parts of themselves,
like in Fight Club or Split, is entirely fictional.
The other major symptom is memory loss oramnesia.
This could be missing personal informationabout themselves,
or missing memories from times when another personality fragment was in control. Also,
it doesn’t count if the personality shift
or memory loss are chemically-induced.
If everyone tells you that you turn
into someone else when you’re drunk,
but you can’t remember what you said ordid …
you do not have dissociative identity disorder. And,
parents: imaginary friends?
They’re really common— like, 2/3 of kidshave them—
and this is not a symptom of your child harboring another secret personality.
But if a patient has multiple identities,their memory is shaky,
and they’re distressed or impaired by thesesymptoms,
then a psychiatrist might diagnose them withDID. Many,
It’s not that their condition isn’t real—
there’s no denying that patients have these symptoms.
But experts disagree on where the symptomscome from—
whether DID is a stand-alone disorder,
or whether it ’ s better explained by other,
Surveys of psychiatrists found that most agreeit’s a valid diagnosis,
but many think it’s commonly misdiagnosed.
That ’ s partly because DID is so rare,
most studies on it have very small samples.
But it ’ s also because it’s very unlikely
that patients get just a DID diagnosis.
It ’ s usually tacked on to other diagnoses,
and this is one reason why many psychologists
think thatit’s better understood as an extreme version
of other disorders.
For example, DID can look a lot like a dissociative fugue state.
This is a kind
of temporary memory loss where people behave impulsively,
leave their homes and wander around,
and do things that they would never otherwise do.
So it might seem like a shift in personality.
These people also often lose their memoriesof who they are,
so they sometimes invent a new identity to fill in the gap.
And although a lot
of these fugue cases are a bit of a mystery,
some are explained by substance use or neurologicalconditions.
DID also overlaps a lot with post-traumaticstress disorder,
That’s especially interesting, because thepsychologists
who most strongly believe DID is a distinctdisorder
think it stems from childhood trauma or abuse— which could also cause PTSD.
And DID similarly shares symptoms with borderlinepersonality disorder,
which is characterized by impulsive behavior, as well as unstable relationships and identity.
One study of 33 patients in the 1980s found
that 70 % of patients with DID
could have just as easily been diagnosed with borderline personality disorder instead. But,
the researchers concluded that because30% of the cases
were distinct, DID should be considered astand-alone disorder.
DID is also controversial because many ofthe new diagnoses
seem to be coming from just a few psychiatrists,
and some suggest these doctors may be overzealous
because they’re eager to find new cases.
But the doctors themselves counter that bysaying that
they’re just better at seeing the signsand identifying the disorder. Regardless,
the good news is
that treatment for DID with tailored therapy—
at least for the symptoms related to identityfragmentation—
is pretty effective.
Which is great, because although there’sa lot of controversy
surrounding the disorder, psychiatrists allagree that
real people are suffering and need help.
And like anyone else, they should be showncompassion,
and not made into movie monsters.
Thanks for watching this episode of SciShow Psych.
If you want to learn more about the psychologyof trauma,
you might be interested in our episode on how trauma can be inherited.